FCIEH, Chartered Environmental Health Practitioner Philip House, 123 York Street, Belfast BT15 1AB, UK.
Perspect Public Health. 2010 Jan;130(1):21-6. doi: 10.1177/1757913909355217.
If asked to describe the key public health challenges of our time many practitioners might well cite issues such as health inequalities, obesity, smoking and poverty. However, with the greatest of respect to those agendas, they are not, in my view, the greatest priority at present. If we cannot learn to live within sustainable limits and damage beyond repair the essential life support systems that we depend on, they will fail catastrophically with horrific consequences for humanity. All credible, reliable scientific evidence suggests that without profound and significant change that is exactly where we are headed. However, there is time, albeit short, to avoid the very worst consequences of runaway climate change. But to do so requires collective and urgent action now! Public health practitioners have potentially so much to offer towards this effort. We have many of the skills and experience so critically needed to advocate for change--both political and behavioural; we have the ability to design creative, effective, and dynamic interventions to assist and facilitate communities and individuals make the journey; and equally importantly we have huge opportunities to do so. However to do so effectively means that we need to look at the problem through a different lens and make climate change a top public health priority. We need to see beyond many of the institutional and cultural barriers that exist, albeit not through deliberate design, within our organisations which can cause us to be focused on very specific agendas and see the whole wood, rather than individual trees within it. Climate change is not just an "environmental" problem and a priority therefore specifically for that sector. It is already costing lives and is life threatening on a scale that far surpasses current public health concerns and priorities. Equally critically, tackling climate change would and will significantly contribute towards addressing health inequalities. To use two well worn public health cliché's, climate change is everyone's business. And it must be a case of prevention because there will be, in this instance, no cure!
如果让从业者描述当前主要的公共卫生挑战，许多人可能会提到健康不平等、肥胖、吸烟和贫困等问题。然而，恕我直言，与这些问题相比，目前当务之急并非这些问题。如果我们不能学会在可持续的范围内生活，不破坏我们赖以生存的基本生命支持系统，这些系统将灾难性地崩溃，给人类带来可怕的后果。所有可靠的科学证据都表明，如果我们不做出深刻而重大的改变，我们就会走向这样的结局。然而，我们还有时间，尽管时间很短，可以避免气候变化失控带来的最严重后果。但是，要做到这一点，现在就需要采取集体和紧急行动！公共卫生从业者在这方面可以做出巨大的贡献。我们拥有许多倡导变革所需的技能和经验——无论是政治上的还是行为上的；我们有能力设计富有创意、有效和动态的干预措施，以帮助和促进社区和个人踏上这一旅程；而且同样重要的是，我们有很多机会这样做。然而，要想有效地做到这一点，我们需要通过不同的视角看待这个问题，将气候变化作为公共卫生的首要任务。我们需要看到我们组织中存在的许多制度和文化障碍，尽管这些障碍并非有意设计，但它们会使我们专注于非常具体的议程，而看不到整体情况，只见树木不见森林。气候变化不仅仅是一个“环境”问题，因此也不仅仅是该领域的优先事项。它已经在夺走生命，而且其威胁生命的程度远远超过当前的公共卫生问题和优先事项。同样重要的是，应对气候变化将大大有助于解决健康不平等问题。用两个公共卫生界常用的陈词滥调来说，气候变化事关每个人的利益。而且这必须是一个预防的问题，因为在这种情况下，没有治愈的办法！
